The Management of Membranous Glomerulopathy in Allogeneic Stem Cells Transplantation: Updated Literature

Title:The Management of Membranous Glomerulopathy in Allogeneic Stem Cells Transplantation: Updated Literature

Volume: 11 Issue: 1

Author(s): Pasquale Niscola, Andrea Tendas, Xiao-dan Luo, Gianfranco Catalano, Laura Scaramucci, Luca Cupelli, Marco Giovannini, Michele Ferrannini, Francesco Bondanini, Daniela Piccioni, Teresa Dentamaro, Roberto Palumbo, Alessio Pio Perrotti, Qi-fa Liu and Paolo de Fabritiis

Affiliation:

Keywords: Allogeneic hematopoietic stem cell transplantation, chemotherapy, conditioning regimen, corticostroids, cyclosporine, glomerulonephritis, graft-versus-host disease, leukemia, lymphoma, membranous glomerulopathy, multiple myeloma, nephrotic syndrome, radiotherapy, renal failure, rituximab

Abstract: Background: membranous glomerulopathy (MG) is an immunomediated disorder which accounts for the most common cause of nephrotic syndrome (NS) following allogeneic hematopoietic stem cell transplantation (HSCT).

Objective and Methods: to provide an update on the issue by reviewing pertinent literature on the MEDLINE database.

Results: sixty-nine post allogenic HSCT patients (42 male) with MG were identified. The median age was 43 (5 to 68) years. Time interval from allogenic HSCT to MG diagnosis ranged from 3 to 134 months (median 17). Most MG patients had a history of acute (70%) or chronic (84%) graft versus host disease (GVHD). Corticosteroids and cyclosporine were the most common therapeutic agents used in this setting; alternative therapies, including rituximab, were given to a lower number of patients. Outcome data were available in 64 out of 69 MG patients; 38 (59%) and 18 (28%) patients achieved a complete and a partial response respectively, whereas treatment failure was recorded in the remaining 8 (13%).

Conclusion: MG after allogenic HSCT appears to be associated with a sub clinical or overt cGVHD, which follows the discontinuation of immunosuppressive prophylaxis. Although a standard therapeutic approach has not been established, the application of available measures can induce favorable response in more than 80% of affected patients, but treatmentfailure and progressive deterioration of the renal function may occur in about one fifth of cases.

Cite this article as:

Niscola Pasquale, Tendas Andrea, Luo Xiao-dan, Catalano Gianfranco, Scaramucci Laura, Cupelli Luca, Giovannini Marco, Ferrannini Michele , Bondanini Francesco, Piccioni Daniela, Dentamaro Teresa, Palumbo Roberto, Pio Perrotti Alessio, Liu Qi-fa and de Fabritiis Paolo, The Management of Membranous Glomerulopathy in Allogeneic Stem Cells Transplantation: Updated Literature, Cardiovascular & Hematological Agents in Medicinal Chemistry 2013; 11 (1) . https://dx.doi.org/10.2174/1871525711311010011